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CLINICAL IMAGE
Year : 2019  |  Volume : 150  |  Issue : 3  |  Page : 312

Regional cardiac tamponade


1 Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram 695 011, Kerala, India
2 Department of Cardiovascular & Thoracic Surgery, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram 695 011, Kerala, India

Date of Submission21-Nov-2017
Date of Web Publication8-Nov-2019

Correspondence Address:
Arun Gopalakrishnan
Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Thiruvananthapuram 695 011, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_1851_17

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How to cite this article:
Gopalakrishnan A, Pillai VV. Regional cardiac tamponade. Indian J Med Res 2019;150:312

How to cite this URL:
Gopalakrishnan A, Pillai VV. Regional cardiac tamponade. Indian J Med Res [serial online] 2019 [cited 2019 Nov 17];150:312. Available from: http://www.ijmr.org.in/text.asp?2019/150/3/312/270622

†Patient's consent obtained to publish clinical information and images.


A 39 yr old hypertensive man presented to the Cardiology Emergency, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India, in September 2017 with extensive Stanford type A aortic dissection extending beyond the renal arteries and severe aortic regurgitation. He underwent emergent supracoronary ascending aortic replacement with 28 mm albograft with arch debranching (ascending bicarotid bypass). On the 9th postoperative day, he presented with breathlessness. All peripheral pulses were palpable and the aortic click was normal. Transthoracic echocardiography showed moderate localized pericardial effusion anterior to the right ventricle with diastolic free wall collapse ([Figure 1] & Video A). The left ventricle was normal. Urgent pericardiocentesis yielded 700 ml of serous fluid and normalized the wall motion abnormalities (Video B). There was mild AR and the neo-aortic root was normal. Subsequently, he underwent thoracic endovascular aortic repair for descending thoracic aortic aneurysm with residual dissection. The patient remained well at four-month follow up.
Figure 1: Two-dimensional transthoracic echocardiographic stills from the parasternal short-axis projection in end diastole. (A) The localized pericardial effusion and diastolic right ventricular free wall collapse (white arrow). (B) Minimal effusion after drainage of pericardial fluid normalization of the right ventricular free wall motion (white arrow). LV, left ventricle; PE, pericardial effusion; RV, right ventricle.

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Video: Two-dimensional transthoracic echocardiographic stills from the parasternal short-axis projection in end diastole. ( A ) The localized pericardial effusion and diastolic right ventricular free wall collapse (white arrow). ( B ) Minimal effusion after drainage of pericardial fluid normalization of the right ventricular free wall motion (white arrow). LV, left ventricle; PE, pericardial effusion; RV, right ventricle.

Conflicts of Interest: None.




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